Difüzyon Ağırlıklı MR Kullanarak Karaciğer Fibrozisinin Non-Invaziv Değerlendirilmesi

Year 2024, , 465 - 471, 31.08.2024

Mehmet Hakan Pıçak , A.hande Yardımcı

https://doi.org/10.54005/geneltip.1438885

Abstract

Amaç: Bu çalışmada, HBV ve HCV'ye bağlı kronik hepatit ve sirozlu hastalarda karaciğer fibrozunun evrelerini karaciğer biyopsisi yerine DWI-MRI ile değerlendirmeyi ve ADC değerlerinin histolojik fibroz evrelemesinin yerine kullanılabilirliğini araştırmayı amaçladık.
Gereç ve Yöntem: Biyopsi ile İshak fibroz skorlama sistemi uygulanmış kronik hepatit tanılı 46 hasta ile radyolojik ve klinik bulgulara göre normal olarak değerlendirilen 11 olgu çalışmaya dahil edildi. Karaciğer fibrozu olan hastaların ve sağlıklı kontrol grubunun ADC değerleri karşılaştırıldı. ADC değeri ile karaciğer fibrozis evreleri arasındaki korelasyon analiz edildi.
Bulgular: ADC değerlerinin fibrozis evresi arttıkça azaldığı gösterildi. Ortalama karaciğer ADC değerleri arasında çok yüksek düzeyde istatistiksel olarak anlamlı fark bulundu (p<0.001). Normalize edilmiş karaciğer ADC değerleri arasında yüksek düzeyde istatistiksel olarak anlamlı fark bulundu (0.001≤p<0.01).
Sonuç: DWI görüntülemesi, birçok görüntüleme merkezinde rutin sekanslar arasında yer almakta, yaygın bir şekilde kullanılmakta ve fibrozis evrelemesinde iyi sonuçlar vermektedir. İleri çalışmalar ile standartlaştırılmış değerlere ulaşılabilir ve daha etkin sonuçlara ulaşmak mümkün olabilir.

Keywords

Difüzyon MR, ADC, Karaciğer, Fibrozis

Non-Invasive Assessment of Liver Fibrosis Using Diffusion-Weighted MRI

Abstract

Background/Aims: In this study, we aimed to evaluate the stage of liver fibrosis in patients with chronic hepatitis and cirrhosis due to HBV and HCV, with DWI-MRI instead of the liver biopsy, and to investigate whether ADC values can practically replace histological fibrosis staging.
Methods: We included 46 cases with diagnosis of confirmed chronic hepatitis whose Ishaac fibrosis scoring were performed and 11 cases were assesed as normal according to radiological and clinical data.The ADC value of liver fibrosis patients and healthy controls was compared. The correlation of ADC value and liver fibrosis staging was analyzed.
Results: The ADC values were demonstrated to be decreased with increasing fibrosis stage.Very high statistical significance was found between the mean liver ADC values (p<0.001). A high level of statistical significance was found between the normalized liver ADC values (0.001≤p<0.01).
Conclusion: DWI images have been among the routine sequences in many imaging centers, are being used extensively, and give good results in the staging of fibrosis. With further studies we can access to standardized values which can lead to more efficient results.

Keywords

liver fibrosis, MRI, DWI, ADC

Ethical Statement

The Institutional Ethics Committee of İstanbul EAH approved this study Year 2017 , number 1114, and informed consent was obtained from all participants.

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